Medical use of cannabis

Under the Misuse of Drugs Act 1971, Cannabis is a controlled drug. The Act makes it illegal for people to possess, supply, produce, or import/export controlled drugs. However, changes to the Misuse of Drugs regulations 2001 in November 2018 has meant that cannabis based medicinal products can be prescribed under certain circumstances.

Review of the scheduling of cannabis medicinal products

There was increased debate on the medical use of cannabis in 2018. Much of this focused on the cases of children with rare and severe forms of epilepsy, whose families reported that they had benefited from the use of medicinal cannabis products.

In a statement on 19 June 2018, the Home Secretary said that the position in the UK on this issue was not satisfactory. He announced that the Government would review the scheduling of cannabis. There were two parts to the review:

Part one was undertaken by the Chief Medical Officer, Professor Sally Davies, and looked at the evidence for the use of cannabis based medicinal products. She reported that there was conclusive evidence of the therapeutic benefit of cannabis medicinal products for certain medical conditions and recommended that the whole class of cannabis based medicinal products be moved out of Schedule 1; and

Part two was undertaken by the Advisory Council on the Misuse of Drugs and provided advice on whether certain products should be rescheduled. Based on its short-term review, the ACMD advised that cannabis derived medicinal products of the appropriate medical standard should not be in Schedule 1 of the regulations.

A change in the law

On 26 July 2018, the Home Secretary announced that, following this advice from the ACMD and the Chief Medical Officer, he had decided to reschedule cannabis derived medicinal products.

In November 2018, the law changed to allow the prescribing of cannabis-based medicines in certain circumstances. The Regulations included a definition of cannabis-based medicines and set out that only doctors on the GMC specialist register could prescribe these.

Prescriptions for cannabis-based medicines and concerns raised

It has been reported that there have been few prescriptions for cannabis-based medicines since the change in the law but full data on this is not available. Patient groups and families have expressed concerns about prescribing and have called for more action in this area. However, professional bodies and senior clinicians have said there is a need for further evidence and have called for randomised controlled trials to look at the benefits and harms of these products.

In response to an Urgent Question on cannabis-based medicines in April 2018, the Secretary of State for Health and Social Care, Matt Hancock, expressed sympathies with the patients and families seeking to use medicinal cannabis but said that the decision to prescribe must remain a clinical one which takes into account the clinical evidence, and the circumstances of the patient. He set out that he would ask NHS England to undertake a review of barriers to prescribing and introduce measures to encourage further research in this area. NHS England has been asked to provide an interim report of this review by the end of May 2019.